Pyridostigmine: Difference between revisions
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Latest revision as of 21:57, 20 March 2026
Administration
- Type: Neostimine analogue, cholinesterase inhibitor
- Dosage Forms: oral immediate or extended release, IV
- Routes of Administration: IV, PO
- Common Trade Names:
- As opposed to physostigmine, pyridostigmine does not cross the blood brain barrier, and is thus a poor agent for agitation and CNS complications
Adult Dosing
- Myasthenia gravis: 60-1500 mg PO daily (immediate release) or 180-540mg PO daily (slow-release)
- Reversal of neuromuscular blocking agents: 0.1-0.25 mg/kg IV
- Organophosphate poisoning prophylaxis: 30mg PO q8h
Pediatric Dosing
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk minimal
- Renal dosing: lower dose may be required, titrate to effect
Contraindications
- Allergy to class/drug
- Mechanical bowel or urinary obstruction
Adverse Reactions
Serious
- Cholinergic crisis
- Bradyarrythmia
Common
- Nausea/vomiting, abdominal cramps, diarrhea
- Muscle cramps, fasciculation, asthenia
- Increased bronchial and salivary secretions
Pharmacology
- Half-life: 3 minutes (IV), 200 minutes (oral)
- Metabolism:
- Excretion: Renal
Mechanism of Action
- Neostigmine analogue; competitive cholinesterase inhibitor→ less acetylcholine breakdown→ more available acetylcholine in synapses
Comments
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Myasthenia gravis | 60 mg QID (titrate to effect) | Acetylcholinesterase inhibitor (symptomatic) | PO | Adult |